Therapeutic approaches in autism spectrum disorders (ASD): A review study
Therapeutic approaches in autism spectrum disorders (ASD): A review study
Zahra Momtahan,1,*Atefeh Ensafi,2Fatemeh Kaviani,3Saghar Gholami,4Mohammad Kavianimanesh,5
1. Department of Genetics, Faculty of New Sciences and Technologies, Tehran Medical Sciences, Islamic Azad Univeristy, Tehran, Iran 2. Department of Psychology, Faculty of Management and Humanities, Firouzabad Humanities, Islamic Azad University, Fars, Iran 3. Department of Psychology, Faculty of Management and Humanities, Firouzabad Humanities, Islamic Azad University, Fars, Iran 4. Department of Psychology, Shiraz branch, Islamic Azad University, Shiraz, Iran 5. Department of Psychology, Faculty of Humanities and Literature, Zand Shiraz Institute of Higher Education, Fars, Iran
Introduction: Autism spectrum disorder or ASD is a neurodevelopmental disease with disability in social and emotional communications, anxiety, restrictive and repetitive behaviors. The prevalence of autism is almost 0.37% in Asia. The etiology of autism is vary heterogeneous, both environmental and genetic factors are involved in autism. Some of the environmental factors such as parent̕ s age, asphyxia-related birth complications and preterm birth. The genetic factors such as SNPs, Copy Number Variations, Single mutation genes, Epigenetic factors. It has been showed that almost 800 genes involving in Synapse function, Chromatin remodeling and cortical development are associated with ASDs. Current autism treatments can mostly be divided into behavioral and medicine approaches. Behavioral treatments mostly include some activities to encourage social communications, self-awareness and increase attention. The medicine approaches improve some specific activities associated with autism prescribing medication. Generally, it has been recommended several treatment strategies, but none of them were effective to cure and eradicate the autism. Some in vivo and ex vivo gene therapy using CRISPR have been done for autism and neurodevelopmental disorders to the aim of therapy or made an animal model for study about autism. The CRISPR method can be a promising therapeutic approach for ASDs. The purpose of this review article is to summarize some of the effective treatment approaches for ASDs.
Methods: In behavioral therapy the Intensive Behavioral Intervention method providing significant profit for core ASD symptoms is a potential technique to treat younger children with autism; especially in premature ages. It has been reported that to improving social interaction, social skills’ groups can be effective. The method of Cognitive Behavioral Therapy can help adults with autism disorder in the context of treating anxiety and Obsessive Compulsive Disorder. Some studies has reported that pharmacological treatments; such as risperidone; fluvoxamine; fluoxetine; divalproex sodium, and placebo; may be effective against restricted/repetitive behavior among patients with ASD. Acupuncture making some therapeutic effects on ASD using activate the hypothalamic oxytocin system releasing of neurotransmitters. In one study has been proved that use of Mesenchymal stem cells combining with cord blood CD34+ cells are effective in the treatment of autism. Moreover, Artificial Intelligence is one of the promising approaches helping diagnose and therapy of ASD in recent decay, in one study an Artificial Intelligence system for Robot-Child interaction has suggested to the aim of behavioral. Several studies have been proved that animal models (e.g. rodent models) can be effective tools specially to find appropriate treatment methods such as gene therapy approaches in neurodevelopmental disease. Knockout and humanized Knock-In mice for various mutations in ASD and comorbid neurodevelopmental disorders have been generated. CRISPR-Cas is one of the cost-effective gene therapy methods using in the recent decades as a promising cure approaches. It has been developed an in vivo newly designed CBE strategy targeting neurons in the brain via a BBB-crossing AAV system; to correcting a single nucleotide mutation in the whole-brain scale; in CRISPR-Cas system.
Results: This review focused on six potential treatment methods for autism patients such as behavioral therapy, pharmacological treatment, traditional medicine, artificial intelligence and gene therapy. However most of these therapeutic approaches are effective to improve the autism symptoms, most of these have focused on the environmental factors causing autism and have not been a final cure for autism. Specifically, there is another remarkable factor, which has played a critical role in etiology of autism. Genetic factors can play a key role to cure some subtypes of ASD such as fragile X syndrome, some polymorphisms like MTRR (rs1801394) and so on. Therefore, CRISPR-Cas system can be a targeted gene therapy to cure these subtypes of ASD.
Conclusion: To conclude, it has introduced several possible therapeutic approaches to improve autism. Among them, gene therapy is the only treatment that has focused on genetic factors of ASD and the most targeted therapy, although others have been helping to improve autism symptoms. Generally, more attention is needed for gene therapy methods in order to create a final and permanent treatment for some subgroups of autism.